Generally, if you use in-network providers, your provider will submit your claims for you. Remember to present your Blue Shield of California PPO or Delta Dental PPO identification card each time you receive services and verify that the providers participate in the network.
If you enrolled in DeltaCare USA DHMO, make sure you go to your assigned dental office and present your DeltaCare USA ID card. If you need an ID card, contact Delta Dental USA at (800) 422-4234.
Once you enroll in Vision Service Plan (VSP), you do not need an ID card to make an appointment. Simply tell your provider you have VSP.
When you use non-network providers and pay in full upfront, you must submit an itemize bill or superbill, proof of payment and, if any, an Explanation of Benefits (EOB) from your primary plan.
If you use an out-of-network provider and you paid in full upfront, you must submit an itemize bill or superbill, your proof of payment and if any, an Explanation of Benefits from your primary plan to the Fund Office.
See the Prescription Drug Benefits section for instructions on how to file a Prescription Drug claim.
Important Note: Claims received more than 12 months from the service date will generally be denied. In some cases, Plan representatives will request more information from the patient or provider before the claim may be processed. Replies to Fund Office requests must be sent within 12 months.
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